Every person or household will have a new calculation on their 1040: MAGI (modified adjusted gross income). If that number puts you at 400% of the poverty level (PL) or less, you are entitled to a subsidy, limiting your premium payment for the second cheapest silver plan to a percentage of your MAGI (it's a sliding scale, your results may differ). So if you have a MAGI of, say, 10,000, this puts you at PL and your silver insurance plan will cost you $200/year. The difference between that and what it actually costs is paid directly to the insurance company by the federal government. The thing is, you can take that subsidy dollar amount and apply it to any plan.

What that means is this: many middle class people are going to have a MAGI that precludes them from subsidies. I was thinking along traditional lines: "Wow, a 100% plan is going to be hideously expensive" and it probably will be, but because the subsidy dollar amount is portable to any plan, lots of people may be able to get a plan that pays 100% of their medical costs for less than they are paying for insurance now. They may not, it depends on the total premium cost, but middle class folks without subsidies almost surely will find that plan unaffordable, and if a significant number of people are able to get on a 100% plan that is subsidized to the point where they can afford it, the demand side of the supply and demand equation is going to go through the roof. This will collapse the availability of medical treatment rather quickly as demand spirals far beyond the ability of what docs and hospitals can provide.